The impact of perceived discrimination on subjective health among adolescents

Abstract Background Interpersonal discrimination (disc.) plays an important role for physical and mental health, througoutthe life-course and in particular during adolescence. People can experience disc., e.g. due to their physical appearance or language preferences independently of having a migration background (mb, official statistical category in Germany). Aim of this contribution is to analyse the impact of perceived disc. on subjective health and its relation to mb. Methods Using data from from German Health Interview and Examination Survey for Children and Adolescents (KiGGS) wave 2 (2014 - 2017), we analysed by logistic regression the impact of a) overall perceived disc. (≥ one indication of “sometimes” across eight dimensions), b) perceived disc. related to origin, skin colour, accent, language, dialect and c) one- and two-sided mb (one or both parents with own mb) on subjective health among adolescents aged 14 to 17 years. Results Among 3,558 adolescents, 21% perceived disc. in at least one of overall eight dimensions, 11% reported disc. related to their origin, skin colour or language. A one-sided mb was measured for 8,4% of participants, a two-sided mb for 20%. Perceiving overall disc. (OR = 3.29) and disc. related to origin, skin colour or language (OR = 1.91) was associated with reporting a (very) bad subjective health. Mb had no impact. Effects remain after controlling for gender, age and socioeconomic position of parents (overall disc. aOR=2.99; disc. related to origin, skin colour or language aOR=1.65). Conclusions Perceived disc. is associated with worse subjective health among adolescents, whereas no association with mb is observed. Epidemiological analyses solely focussing on one statistical category such as mb are insufficient as they do not consider those affected by discrimination but are not captured by mb. Differentiated analyses are necessary to elucidate explanatory mechanisms and protective factors. Key messages Discrimination has negative effects on self-rated subjective health. Differentiated analyses based on more than “origin” or “migration background” is required to describe public health.


Background:
People with migration history (PMH) are underrepresented within health monitoring at Robert Koch Institute (RKI). To better describe the health status of PHM, the RKI is currently conducting the health interview survey GEDA Fokus with different migrant groups. Aim of this contribution is to present which sub-groups in this sequential mixed-mode survey design are reached by which mode. Methods: People aged 18-70 years with Croatian (hr), Italian (it), Polish (pl), Syrian (sy) or Turkish (tr) nationality were drawn out of 99 residents' registration offices all over Germany (N = 33,436). Study persons were invited sequentially to participate online (saq-web), paper-based(saq-paper) and in person (CAPI) or by telephone (CATI) in Arabic, Croatian, German, Italian, Polish or Turkish. Saq-web was available in German only or bilingual. Data collection took place from November 2021 to April 2022. Per nationality, 1,200 participants were recruited.

Conclusions:
Preliminary results show that offering multiple modes of administration helps to reach different sub-groups. Personal contact contributes to reach those not directly taking part on their own initiative. The opportunity to utilize the bilingual version of the questionnaire was well accepted, especially among those with presumably shorter duration of residence in Germany.

Key messages:
Offering different modes of survey administration, including personal contact increases survey participation. In order to reach people with migration history in their heterogeneity the utilization of multilingual questionnaires is crucial.
Abstract citation ID: ckac130.201 The impact of perceived discrimination on subjective health among adolescents independently of having a migration background (mb, official statistical category in Germany). Aim of this contribution is to analyse the impact of perceived disc. on subjective health and its relation to mb.

Methods:
Using data from from German Health Interview and Examination Survey for Children and Adolescents (KiGGS) wave 2 (2014 -2017), we analysed by logistic regression the impact of a) overall perceived disc. ( one indication of ''sometimes'' across eight dimensions), b) perceived disc. related to origin, skin colour, accent, language, dialect and c) one-and two-sided mb (one or both parents with own mb) on subjective health among adolescents aged 14 to 17 years.

Results:
Among 3,558 adolescents, 21% perceived disc. in at least one of overall eight dimensions, 11% reported disc. related to their origin, skin colour or language. A one-sided mb was measured for 8,4% of participants, a two-sided mb for 20%. Perceiving overall disc. (OR = 3.29) and disc. related to origin, skin colour or language (OR = 1.91) was associated with reporting a (very) bad subjective health. Mb had no impact. Effects remain after controlling for gender, age and socioeconomic position of parents (overall disc. aOR = 2.99; disc. related to origin, skin colour or language aOR = 1.65).

Conclusions:
Perceived disc. is associated with worse subjective health among adolescents, whereas no association with mb is observed. Epidemiological analyses solely focussing on one statistical category such as mb are insufficient as they do not consider those affected by discrimination but are not captured by mb. Differentiated analyses are necessary to elucidate explanatory mechanisms and protective factors. Key messages: Discrimination has negative effects on self-rated subjective health. Differentiated analyses based on more than ''origin'' or ''migration background'' is required to describe public health.

Background:
Health information management systems (HIMS) are used by most countries to record data on the coverage of reproductive, maternal, newborn and child health services (RMNCH). The HIMS in India manually collects data from primary health care facilities. Low and middle income countries (LMIC) are shifting to technological applications (apps) to improve reporting and real time tracking of RMNCH services. This study found high disparity of data between different sources. Yet governments and other stakeholders continue to use poorly reported data for daily monitoring, review and decision making. This study shares insight on the high degree of data variation, and proposes process and policy changes to improve it.

Methods:
To quantify the extent of data variation, critical RMNCH indicators from apps and HIMS are compared for a given geography and time period. Workshops with the primary health workers and their supervisors were conducted to understand the challenges in reporting, based on which solutions to improve the efficiency of apps are proposed.

Results:
Preliminary analysis in the state of Madhya Pradesh shows, in the year 2020-2021 live births, neonatal deaths and Infant deaths were 93%, 91% and 71% less respectively on apps as compared to HIMS. Major challenges of reporting on technological applications by primary health workers low internet penetration at 31% in Madhya Pradesh Lack of mechanisms to ensure user friendly and glitch-free apps Poor capacity to understand public health indicators and application generated reports

Conclusions:
Online data quality must be governed by policies that focus on implementing mechanisms to analyze and validate data from different sources and remove blockages to quality reporting. Online public health reports need to be demystified by building capacities of primary health workers and their supervisors to use data to reflect on their performance and plan for improvement. Key messages: Poor online data will impact real time action to ensure coverage and accountability for low performance. Investing in user friendly efficient technology for RMNCH services with strong quality control mechanisms, is the priority for good decision making.

Background:
Little is known about working years lost (WYL) due to work disability and unemployment by industrial sector. This information would help in directing interventions promoting healthy working careers, knowing that the sectors have been differently affected by economic fluctuations and other changes in the labour market. We examined trends in WYL in the general Finnish population and by industrial sector in the period after the 2008 financial crisis with a particular focus on different types of work disability.

Methods:
Utilising register data on the Finnish working-age population and the Sullivan method, we calculated expected WYL due to sickness absence, other temporary work disability, partial disability retirement, full disability retirement, unemployment and other reasons in years 2010, 2013 and 2016 for the general male and female populations and by industrial sector.

Results:
In 2010, a 30-year-old person was expected to have around two-and-a-half to three WYL due to full disability retirement and unemployment until reaching age 65, depending on gender and the reason. By 2016, WYL due to full disability retirement decreased to less than two years and that due to unemployment increased to around four years among both genders. WYL due to sickness absence, other temporary work disability, partial disability retirement and other reasons remained relatively stable. The total WYL increased between 2010 and 2016 particularly among women. The differences by industrial sector in WYL were attributable more to unemployment than to the different work disability statuses.

Conclusions:
After the financial crisis unemployment appears to have replaced disability retirement as the most important reason for WYL. Furthermore, as individuals with a defined industrial sector are initially employed, sectoral differences in WYL are not largely attributable to disability retirement, disability pensioners typically having been outside the labour market for a long time. Key messages: During economic downturns work disability may be increasingly disguised as unemployment, which should be